感觉神经端侧缝合后神经再生趋化性的实验研究

目的：探讨感觉神经端侧缝合后神经再生的趋化性问题。方法：健康雌性SD大鼠20只，分为神经端侧缝合组和正常对照组，每组10只。端侧缝合组切断前臂内侧皮神经，尺神经后内侧方外膜开窗，将前臂内侧皮神经和开窗的尺神经外膜做端侧缝合，正常对照组仅显露前臂内侧皮神经和尺神经。1年后采用乙酰胆碱酯酶染色和Fluoro—Gold荧光逆行示踪技术，观察和计数前臂内侧皮神经纤维和大鼠脊髓C5-T1前角和背根神经节神经元。结果：乙酰胆碱酯酶染色结果显示，正常组未发现运动神经纤维，端侧缝合组有髓神经纤维数目是正常对照组的23．0％（P〈0．01），运动神经纤维占有髓神经纤维的比例为0．34±0．16（P〈0．01）。神经元逆行荧光示踪结果显示，正常组脊髓前角未发现荧光标记阳性的神经元；端侧组脊髓前角荧光标记神经元数目为150．9±104．8（P〈0．01），运动神经元比例为0．27±0．11（P〈0．01）。结论：感觉神经端侧缝合后神经侧方出芽对特定靶器官的趋化性不明显。

Experimental study of neurotropism following end-to-side neurorrhaphy of sensory nerve

Objective： To detect whether there is neurotropism following end-to-side neurorrhaphy of sensory nerve. Methods： Twenty female Sprague-Dawley rats were divided into 2 groups： end-to-side neurorrhaphy group and normal control group. In the end-to-side group, the cutaneous antebrachli medialis nerve（CAM） was transected, then an i mm epineural window was created on the ulnar nerve. Distal end of CAM nerve was sutured to the windowed ulnar nerve by means of end-to-side neurorrhaphy. In the normal control group, CAM and ulnar nerves were exposed. One year post-operatively, evaluations including acetylcholinesterase （AchE） stain and retrograde Fluoro-Gold neuron tracing were conducted. Results： AchE staining showed that in the endto-side group myelinated nerve fiber count was 23.0% as compared to normal control group （P〈0.01）, and the percentage of motor fibers in the end-to-side group was 0.34 ± 0.16 （P〈0.01）. Retrograde neuron tracing demonstrated that the motor neuron counts in CAM end-to-side group were 150.9±104.8 （P〈0.01）, and the percentage of motor neuron in the end-to-side group was 0.27 ± 0.11 （P〈0.01）. Conclusion： Neurotropism in collateral spouting after end-to-side neurorrhaphy of sensory nerve is not significant.